Individual
JOSEPH WAYNE GRANADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-1900
(850) 687-0077
Mailing address
169 ASHLEY AVE RM 202, CHARLESTON, SC 29425-8905
(850) 687-0077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
41842
AL
207RG0100X
Gastroenterology Physician
Primary
MMD.89743
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2019
Last updated
05/24/2023
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